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Tang EYH, Price CI, Robinson L, Exley C, Desmond DW, Köhler S, Staals J, Yin Ka Lam B, Wong A, Mok V, Bordet R, Bordet AM, Dondaine T, Lo JW, Sachdev PS, Stephan BCM. Assessing the Predictive Validity of Simple Dementia Risk Models in Harmonized Stroke Cohorts. Stroke 2020; 51:2095-2102. [PMID: 32568644 PMCID: PMC7306263 DOI: 10.1161/strokeaha.120.027473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Stroke is associated with an increased risk of dementia. To assist in the early identification of individuals at high risk of future dementia, numerous prediction models have been developed for use in the general population. However, it is not known whether such models also provide accurate predictions among stroke patients. Therefore, the aim of this study was to determine whether existing dementia risk prediction models that were developed for use in the general population can also be applied to individuals with a history of stroke to predict poststroke dementia with equivalent predictive validity.
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Affiliation(s)
- Eugene Y H Tang
- Population Health Sciences Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, United Kingdom (E.Y.H.T., C.I.P., L.R., C.E.)
| | - Christopher I Price
- Population Health Sciences Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, United Kingdom (E.Y.H.T., C.I.P., L.R., C.E.)
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, United Kingdom (E.Y.H.T., C.I.P., L.R., C.E.)
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, United Kingdom (E.Y.H.T., C.I.P., L.R., C.E.)
| | | | - Sebastian Köhler
- School for Mental Health and Neuroscience, Maastricht University, the Netherlands (S.K.)
| | - Julie Staals
- Department of Neurology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, the Netherlands (J.S.)
| | - Bonnie Yin Ka Lam
- Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, Gerald Choa Neuroscience Centre, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong SAR (B.Y.K.L., A.W., V.M.)
| | - Adrian Wong
- Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, Gerald Choa Neuroscience Centre, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong SAR (B.Y.K.L., A.W., V.M.)
| | - Vincent Mok
- Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, Gerald Choa Neuroscience Centre, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong SAR (B.Y.K.L., A.W., V.M.)
| | - Regis Bordet
- University Lille, Inserm, CHU Lille, U1171-Degenerative and Vascular Cognitive Disorders, France (R.B., A.-M.B., T.D.)
| | - Anne-Marie Bordet
- University Lille, Inserm, CHU Lille, U1171-Degenerative and Vascular Cognitive Disorders, France (R.B., A.-M.B., T.D.)
| | - Thibaut Dondaine
- University Lille, Inserm, CHU Lille, U1171-Degenerative and Vascular Cognitive Disorders, France (R.B., A.-M.B., T.D.)
| | - Jessica W Lo
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia (J.W.L., P.S.S.)
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia (J.W.L., P.S.S.).,Neuropsychiatric Institute, Prince of Wales Hospital, Sydney (P.S.S.)
| | - Blossom C M Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, UK (B.C.M.S.)
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Bordet R, Vergriete V, Bordet AM, Cordonnier C, Labreuche J, Leys D. Abstract T MP112: Physical Activity Improves Stroke Outcome Through Modulation of Neutrophil Polynuclear Mobilization. Stroke 2015. [DOI: 10.1161/str.46.suppl_1.tmp112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Physical activity has been previously reported to decrease severity of stroke in patient cohorts. Experimentally, in rats submitted to chronic physical activity, the infarct size is decreased and functional outcome is improved, with a decrease of neutrophil polynuclear mobilization.
Hypothesis:
We assessed the hypothesis that beneficial effect of physical activity observed in stroke could be related to neutrophil modulation.
Methods:
We recruited patients with supratentorial cerebral ischemia within 48 hours of symptom onset. We evaluated the presence, weekly duration and intensity (light, moderate, heavy) of previous physical activity. The primary end-point was the initial severity assessed by the NIHSS. The secondary end-point was neutrophil polynuclear count. Myeloperoxydase, chemokines (Monocyte Chemoattractant Protein-1, C-X-C chemokine 10), adhesion proteins (InterCellular Adhesion Molecule-1, vascular cell adhesion molecule1), von Willebrand factor, cytokines (interleukins-6, -8, -10) were dosed in plasma through Luminex methodology.
Results:
Of the 434 patients (mean age of 67 ± 15 years, 53% of men), 227 (52.3%) had a regular physical activity before ischemic event. Previous regular physical activity was independently associated with a lower severity of ischemic event assessed by the NIHSS (4.0 [1-9] vs 6.0 [2-15] ; p<0.002) and lower concentrations of neutrophil polynuclear (5.0 [3.8-6.4] vs 5.7 [4.1-7.7]; p<0.003), chemokines, interleukins, Von Willebrand factor, and myeloperoxydase. There was no strong evidence of difference in biological parameters according to duration of physical activity. Patients with moderate and heavy intensity had a lower level of chemokines, interleukins-8 and Von Willebrand factor.
Conclusion:
In conclusion, previous regular physical activity improves initial stroke severity through decrease of neutrophil polynuclear count. The decrease of attractant chemokines could suggest a decreased mobilization of neutrophils to parenchyma rather than an effect on neutrophil-endothelium interaction since adhesion proteins are not changed.
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